PURPOSE Conventional treatment of chronic hypoparathyroidism consists of oral calcium supplements and active vitamin D analogs; however, some patients are unable to meet treatment goals despite the high dosage of oral calcium supplementation. We aimed to investigate the effectiveness of alternate-day oral calcium intake in patients with uncontrolled chronic hypoparathyroidism. METHODS In this retrospective cohort study, we evaluated 66 patients with chronic hypoparathyroidism who were admitted to our hospital between January 2017 and January 2019. Fourteen patients receiving ≥ 2000 mg/day oral elemental calcium and who were admitted to emergency department or our outpatient clinic at least once in the last 3 months for hypocalcemia requiring intravenous calcium replacement were switched to the alternate-day dosing regimen in which patients took calcium orally every other day. We collected and analyzed patients' medical history information, serum and urinary parameters over a 3-month period prior to and following the treatment. RESULTS Before alternate-day dosing regimen, median oral calcium intake was 3750 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 7.71 mg/dL, serum phosphate levels were 5.35 mg/dL, and 24-h urine calcium levels were 165 mg/day. Following alternate-day dosing regimen, median oral calcium intake was 1500 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 8.25 mg/dL, serum phosphate levels were 5 mg/dL, and 24-h urine calcium levels were 210.5 mg/day. After alternate-day dosing regimen, oral calcium intake decreased and serum calcium levels increased. The number of emergency visits dropped from 21 to 3 after alternate-day dosing regimen. CONCLUSION Patients with uncontrolled chronic hypoparathyroidism could be controlled more effectively with alternate-day dosing regimen.

中文翻译：

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隔日补钙可能是慢性甲状旁腺功能低下的有效治疗选择。

目的慢性甲状旁腺功能减退症的常规治疗包括口服钙补充剂和活性维生素D类似物。但是，尽管口服钙补充剂的剂量很高，但仍有一些患者无法达到治疗目标。我们旨在研究隔日口服钙摄入量对慢性甲状旁腺功能低下患者的有效性。方法在这项回顾性队列研究中，我们评估了2017年1月至2019年1月间入院的66例慢性甲状旁腺功能低下患者。十四名接受≥2000 mg /天口服元素钙的患者，并且在过去三个月中因血钙不足而需要静脉补钙的低钙血症至少进入一次急诊科或我们的门诊的患者，改用隔日给药方案，即患者服用钙每隔一天口服一次。我们收集并分析了治疗前后3个月内患者的病史信息，血清和尿液参数。结果在隔天给药方案之前，口服钙的中位数为3750 mg / d，口服骨化三醇的含量为0.88 mcg / d，血清钙水平为7.71 mg / dL，血清磷酸盐水平为5.35 mg / dL，以及24小时尿钙水平为165毫克/天。隔日给药后，口服钙的中位数为1500毫克/天，口服骨化三醇的摄入量为0.88 mcg /天，血清钙水平为8.25 mg / dL，血清磷酸盐水平为5 mg / dL，24小时尿钙水平为210.5 mg /天。隔日给药后，口服钙摄入减少，血清钙水平升高。隔天给药方案后，紧急就诊次数从21减少到3。结论隔日给药方案可更有效地控制慢性甲状旁腺功能低下的患者。